Only 8 mosquito bites in...

Maybe the mosquitoes know I’m here to stay..they’ve given up feasting on me? Fingers crossed! 

Forging ahead we spent a few hours on some more advanced ultrasound techniques as well as the use of ultrasound in bedside procedures in patients where access may be difficult. Below two of my three champions of ultrasound in Dhaka are doing a bedside focused echocardiogram with little to no added guidance from me.

We went on to discuss what other ways we could work together to improve care. During our discussion the power went out, a common problem that may occur. Usually there are generators however sometimes the ventilatorr may fail if there is no back up battery. Maintenance of machines can be problematic and just having a systematic way to assess quality improvement and assurance is something that the team is working on. As far as improving the critical care education they are using the lectures that I provided them and building their own as well. These lectures are power point presentations that over the course of three years my co-fellows from NYU and I had created and they so generously shared! Beyond that acquiring such machinery as a bronchoscope for the ICU and working dialysis machines are ongoing challenges.

Tomorrow we start another round of training sessions! Hopefully we can be as successful as last year!

In other news: Bangladesh has recently jumped to the top of the charts with air pollution...having mild asthma of my own it is very clear that air quality is a problem as I can feel it any time I am outside for any period of time. I can only imagine the effect that repeated exposure is having on those that live here and are outside every day! 

The positive of today, Day 3 and just barely some GI discomfort! Maybe my gut flora are adjusting faster this year !